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HomeMy WebLinkAboutInsurance Certificate: KOGAP Enterprises Inc (3) KOGA01 W OP to: KCF A~CORO CERTIFICATE OF LIABILITY INSURANCE 091 F D18120/5 Y) 18/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT United Risk Solutions, Inc. NAME: KC Ferguson PO Box 936 a= o Ext : 541-494-7752 JC, No : 541-245-1112 Medford, 97501.0067 -E-MAIL SS: kc.ferguson@unitedrisk.com ADDRESS: C.J. Shipley ey INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : SAIF Corporation INSURED IWGAP Enterprises, Inc. INSURER B P 0 Box 1608 Medford, OR 97501 INSURER C : INSURER D : INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. It R TYPE OF INSURANCE ~A6 SU MPOLICY EFF POLICY EXP I INSD I WVD POLICY NUMBER MlDDIYYYY MMIDD/YYYY i LIMITS j COMMERCIAL GENERAL LIABILITY' EACH OCCURRENCE $ A CLAIMS-MADE Imo: OCCUR PREMISES (Ea occurrence) 1 1 $ I MED EXP (Any one person) $ PERSONAL & ADV INJURY j $ I G_EN'L AGGREGATE LIMIT APPLIES PER: !!GENERAL AGGREGATE $ i POLICY ~I PRO- If r- JECT `JLOC i PRODUCTS - COMP/OP AGG $ OTHER: $ i AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT j _1Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED r- ' AUTOS Y I AUTOS BODILY INJURY (Per accident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS $ (~I Per accident} - UMBRELLA LIAR ( ' I OCCUR L--' EACH OCCURRENCE EXCESS LIAR I CLAIMS•MADE i - ~ i AGGREGATE DED I RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN X STATUTE ER H A . ANY PROPRIETOR/PARTNERIEXECUTIVE 1,754670 110/01/2015 10/01/2016 E. L. EACH ACCIDENT $ 500,000 M BER EXCLUDED. N! r•+ _ _ (Mandatory In ) If yes, describe under E.L. DISEASE - EA EMPLOYE $ 500,000 - I DESCRIPTION OF OPERATIONS below E.L DISEASE -POLICY LIMIT $ 500,000 i I ! I I i I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: All Operations of the Named Insured Project: Oak Street Railroad Crossing CERTIFICATE HOLDER CANCELLATION CITAS03 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 E. Main St. Ashland, OR 97520-1814 AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD